RSVP: Important changes coming to Medicare

Sunday, June 23, 2013

So much seemingly conflicting information about health insurance is reported on a daily basis that seniors seeking answers about Medicare often are fearful and confused, according to RSVP of Montgomery County’s APPRISE Medicare counselors. Apprise is a free and confidential health insurance counseling program designed to help older Pennsylvanians with Medicare. Counselors are state trained volunteers who can answer questions about Medicare and provide objective, easy-to-understand information about Medicare, Medicare Supplemental Insurance, Medicaid, and Long-Term Care Insurance.

Notice of Important ChangesOn July 1, Medicare will be starting a national mail-order program for diabetic testing supplies covered under Medicare Part B that are delivered to an individual’s home. Examples of Part B covered testing supplies are blood sugar monitors, lancets, and test strips. After July 1, all beneficiaries in Pennsylvania who have Original Medicare and who want to have diabetic testing supplies delivered to their homes must use a national mail-order contract supplier to get these supplies paid for by Medicare. Approved Medicare suppliers can be located by entering your zip code on www.medicare.gov website. Beneficiaries will still have the option to go to a retail pharmacy that participates with Medicare or a local Medicare-enrolled supplier storefront to get their diabetic testing supplies. Medicare beneficiaries who get their coverage through a Medicare Advantage Plan should contact their plan to find out how to get their diabetic testing supplies.

Original Medicare beneficiaries living in Montgomery, Bucks, and Philadelphia counties will soon be required to use contracted suppliers to get many types of medical equipment. Medicare began its Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program in January 2011 in nine areas around the country in an effort to help control Medicare’s costs for medical equipment and supplies and to save money for beneficiaries and taxpayers. The DMEPOS program only affects individuals who receive their Medicare through the Original Medicare program (use the red, white and blue Medicare card). Those Medicare beneficiaries must be sure their supplier is approved by Medicare. Information is provided on www.medicare.gov. A list of Medicare approved suppliers can be found by entering your zip code on the website. Check the item of Durable Medical Equipment (DME) needed and look for the “m” posted with the supplier’s name to be sure they accept assignment.

Consumers who get their Medicare coverage through a Medicare Advantage plan are not impacted by this DMEPOS program, but instead must get their medical equipment or supplies through a provider that participates in their particular plan’s network.

Medicare will help pay for DMEs furnished by your physician or by the hospital if you have been admitted even if they are not a contract supplier.

Good News about the Affordable Care Act According to information from Medicare.gov Medicare beneficiaries will receive more benefits. Preventive services such as mammograms and colonoscopies with no co-pays or deductibles as well as yearly wellness visits to physicians now are covered by Medicare. Changes to the prescription drug program will save money and the “donut hole” will be closed by 2020. The life of the Medicare Trust Fund will be extended by 12 years ensuring coverage through 2029, and reduction in fraud and waste will bring down premiums and copays.

Sequestration, a program of budget cuts put in place on March 1 by the federal government limits funding of some health and social welfare programs. Medicare providers, hospitals and healthcare professionals will receive a 2% reduction in payments. Programs such as Meals on Wheels, LIHEAP and Head Start likewise will experience cuts. On the other hand, Medicaid, SSDI, SSI, CHIP, and SNAP (food stamps) will not be affected. The Sequestration remains in effect until Congress changes the law that requires it to take place. Seniors need to contact the program to see how it affects their assistance or coverage.

If you need additional information about Medicare, state-trained Apprise Medicare counselors are available through RSVP of Montgomery County to advise you. RSVP Apprise Medicare counselors staff senior centers, libraries, Aging & Adult Service offices and various venues around the county. To learn more about their services and locations visit http://www.rsvpmc.org/content/apprise-medicare-counseling or call 610-834-1040 ext. 20.

RSVP of Montgomery County for 40 years has been helping adults interested in community service find just the right challenge. Please take a look at RSVP’s exciting venture in virtual education, MyFreeTutor, an online math and science tutoring program for middle and high school students that volunteer tutors can do from home. Contact Harriet Klein 610-834-1040, ext. 22 or harrietk@rsvpmc.org.